The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on wireless capsule endoscopy for investigation of the small bowel.

Description

Obscure gastrointestinal bleeding is defined as bleeding of unknown origin that persists or recurs after a negative initial endoscopy (colonoscopy and/or upper gastrointestinal endoscopy). Diagnosis may be difficult because bleeding can often be slow and/or intermittent. Patients may experience prolonged blood loss, leading to iron deficiency (anaemia) and a feeling of tiredness.

Small intestinal bleeding can result from a number of conditions, including vascular lesions (angiodysplasia), small bowel tumours, coeliac disease and Crohn’s disease (which may be suspected because of other symptoms).

The patient swallows a small capsule, usually after an overnight fast. This capsule consists of a camera, a light source and a wireless circuit for the acquisition and transmission of signals. As the capsule moves through the gastrointestinal tract, images are transmitted to a data recorder, worn on a belt outside the body. These data are transferred to a computer for interpretation. The capsule is then passed in the patient’s stool and not used again.

OPCS4.6 Code(s)

Procedure

SNOMED CT preferred term (concept ID)

Capsule endoscopy of small intestine (446885004)

Wireless capsule endoscopy (199001000000103)

OPCS-4.7

G80.2 Wireless capsule endoscopy

The NHS Classifications Service of NHS Connecting for Health is the central definitive source for clinical coding guidance and determines the coding standards associated with the classifications (OPCS-4 and ICD-10) to be used across the NHS. The NHS Classifications Service and NICE work collaboratively to ensure the most appropriate classification codes are provided. www.connectingforhealth.co.uk/clinicalcoding

Diagnosis or health condition

SNOMED CT preferred term (concept ID)

Small intestinal haemorrhage (70375006)

SNOMED CT provides clinical terms for entry into the patient record to store clinical information relevant to that encounter. The mandated classifications (OPCS-4 or ICD-10) provide a method to collect and aggregate data to allow accurate and consistent data analysis.

The Clinical Classifications Service of the Health and Social Care Information Centre is the central definitive source for clinical coding guidance and determines the coding standards associated with the classifications (OPCS-4 and ICD-10) to be used across the NHS. The Clinical Classifications Service and NICE work collaboratively to ensure the most appropriate classification codes are provided. Clinical Classifications Service — Health and Social Care Information Centre